Substance Abuse in the Air Force

Key Takeaways

• Substance use in the Air Force leads to serious risks such as depression, suicide, and impaired performance.
• The ADAPT program is central to the Air Force’s efforts to prevent and treat substance misuse.
• Historical substance use in the Air Force has evolved, with policies shifting from treatment to deterrence over time.
• Post-9/11, increased deployments have been linked to higher rates of substance use disorders (SUDs) among military personnel.
• The Air Force maintains a ‘zero tolerance’ policy for illicit drug use, with strict testing and rehabilitation programs.
• Substance use impacts operational effectiveness, unit cohesion, and morale and is associated with higher rates of PTSD.
• Recent policy shifts, such as the Air Force marijuana waiver pilot program, reflect changing societal norms and recruitment challenges.
• Future challenges in substance use trends require ongoing research and adaptation of evidence-based practices.

Understanding Substance Abuse in the Air Force

Substance use within the Air Force poses significant risks to personnel, including heightened chances of depression, suicide, and other serious issues. Notably, substance use can stem from attempts to cope with underlying problems and can lead to impaired performance, financial difficulties, marital strife, and adverse career consequences. Alcohol misuse is particularly prevalent, with signs ranging from drinking in dangerous situations to mood swings and impaired coordination. Drug use is equally concerning, with the Air Force maintaining a zero-tolerance policy towards illicit drug use as it is deemed incompatible with service and a breach of discipline.

Addressing substance use, the Air Force has implemented comprehensive policies such as the Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program, which seeks to promote readiness and wellness by preventing and treating substance misuse. This initiative underscores the Air Force’s commitment to the well-being of its personnel and the successful accomplishment of its mission. The program aims to provide education, prevention, and treatment options to minimize the negative impact of substance use on individuals and operations.

Given the unique challenges faced by Air Force personnel, including the stressors of military life, it is crucial to understand the types of substance misuse prevalent and the efforts made to combat them. This not only ensures the health and safety of individuals but also maintains the operational effectiveness and integrity of the Air Force as a whole.

The Evolution of Substance Abuse in the Air Force

The Air Force, like all branches of the military, has faced challenges with substance use among its ranks. Historically, the prevalence and types of substance use within the Air Force have evolved, influenced by both internal policies and broader societal trends. 

Substance Abuse Among Air Force Personnel During the Vietnam War

The Vietnam War marked a significant period in the history of substance use within the US military, particularly among Air Force personnel. The widespread availability and use of narcotics such as heroin and opium were reported, with approximately 20% of veterans indicating weekly use and signs of addiction. This era saw two distinct phases: an initial uptick in marijuana consumption followed by the introduction of highly potent heroin in 1970, which led to addiction among a substantial portion of enlisted troops.

Commanders inadvertently facilitated the proliferation of drugs, with substances ranging from heroin to amphetamines to marijuana becoming commonplace. The military’s response included the implementation of drug urinalysis programs to identify returning service members who were using drugs. Additionally, a staggering 225 million tablets of stimulants, predominantly Dexedrine (dextroamphetamine), were used by the armed forces between 1966 and 1969.

Research into the long-term effects of this era’s substance use continues as Vietnam-era veterans now approach their eighth decade of life. The impact of substance use on their physical and mental health is a subject of ongoing study. The historical perspective on drug use during the Vietnam War underscores the complexities of managing substance use in military settings and the enduring consequences on veterans’ lives.

Trends in Substance Abuse in the Air Force Post 9/11

After the events of 9/11, the Air Force, like other military branches, observed changes in substance use trends among its personnel. The period following 9/11 saw increased deployments and combat exposure, which have been linked to higher rates of substance use disorders (SUDs) in military populations. Research indicates that service members who were deployed to Iraq and Afghanistan are at a greater risk for developing SUDs compared to their non-deployed counterparts. A 2013 study revealed that 44% of returning service members faced challenges with the transition to civilian life, including the onset of problematic substance use behaviors.

Combat-related stress and the reintegration into civilian life post-deployment are significant factors contributing to substance use. The prevalence of tobacco use, heavy alcohol consumption, and prescription drug misuse has been a concern, with military policies and smoking cessation programs being implemented to address these issues. The Department of Defense has prohibited tobacco use in its medical facilities and aims for tobacco-free installations. Additionally, the military has seen a substantial increase in the misuse of prescription medications, particularly opioids, which necessitates more training for providers in pain management and the risks of opioid medication.

One of the most notable co-occurring conditions with SUDs in the military is post-traumatic stress disorder (PTSD). Studies have found that a significant number of veterans with PTSD also struggle with SUDs, which complicates their treatment and recovery. The integration of treatments addressing both PTSD and SUDs has become a focus in recent years, showing promise in improving outcomes for affected service members. The Air Force and the broader military community continue to develop and advocate for evidence-based practices to better serve those dealing with the dual challenges of PTSD and SUDs.

Air Force Substance Abuse Policies and Regulations

The United States Air Force has established stringent policies and programs to address substance use within its ranks. 

Air Force Drug Testing Policies and Procedures

The United States Air Force maintains a stringent drug testing program to ensure the readiness and reliability of its personnel. In alignment with the Department of Defense’s zero-tolerance policy on illegal drug use, the Air Force conducts regular and random drug testing. A notable development in their drug testing policy includes the inclusion of fentanyl and norfentanyl in the Drug Demand Reduction Program labs’ testing panel since March 2019, reflecting the evolving nature of substance use threats.

According to the Air Force Manual 44-198, the Air Force’s drug testing methods primarily involve urinalysis. The types of drug testing executed include random testing, probable cause testing, consent testing, commander-directed testing, and testing upon accession. The Air Force has also established a waiver program that allows some applicants who tested positive for THC, the active component in marijuana, to still join, underlining a shift in policy to adapt to changing societal norms around marijuana use.

The Air Force’s only forensic toxicology drug testing laboratory, located at Lackland AFB, Texas, is a cornerstone of the service’s commitment to deterring illicit drug use. As part of the Defense Department, the Air Force has expanded drug testing for military applicants to include a 26-drug panel that mirrors the testing conducted for active military members. This comprehensive approach to drug testing underscores the Air Force’s dedication to maintaining operational effectiveness and the health and safety of its personnel.

Support and Rehabilitation for Air Force Personnel Facing Substance Abuse

The Air Force is committed to addressing substance misuse among its personnel through various programs and initiatives. The Alcohol and Drug Abuse Prevention and Treatment (ADAPT) program is a cornerstone of this effort, providing comprehensive services to promote readiness, health, and wellness. On active orders, ADAPT is available to active duty service members, including Guard and Reserve members, offering prevention, treatment, and rehabilitation services worldwide.

Key components of the ADAPT program include:

• Preventative measures to deter substance misuse.
• Intervention strategies for those at risk.
• Reintegration support following treatment.

Additionally, the program works with the Violence Prevention Integrator, Community Support Coordinator, and Community Action Team to tailor efforts to the specific needs of the installation. Airmen are encouraged to seek assistance proactively through their unit commander, first sergeant, substance use counselor, or a military medical professional, especially before any incidents occur, as outlined in AFI 44-121.

For those dealing with the dual diagnosis of substance use disorders (SUDs) and PTSD, the Air Force emphasizes evidence-based practices and trauma-informed care interventions. Recognizing the higher rate of comorbidity among PTSD and SUD in military populations, these specialized treatments aim to address both conditions simultaneously, enhancing the chances for successful recovery, according to recent clinical studies.

Operational Impact of Substance Abuse in the Air Force

Substance use within the Air Force significantly affects operational effectiveness and readiness. Research indicates that service members, especially those deployed in combat zones, face a heightened risk of developing substance use disorders (SUDs), with deployment to Iraq and Afghanistan showing notably higher rates of SUD diagnoses than civilian populations. Studies reveal that recently deployed personnel are 1.36 times more likely to develop an alcohol use disorder and 1.14 times more likely to develop a drug use disorder compared to their non-deployed counterparts.

The comorbidity of post-traumatic stress disorder (PTSD) and substance use further complicates the issue, as a significant portion of those seeking treatment for alcohol use disorder also meet the criteria for PTSD. This dual diagnosis can lead to severe consequences for mental health and operational capability. Substance use can result in decreased performance, health issues, and increased risk of accidents, compromising the safety and effectiveness of Air Force operations.

Despite the establishment of the Alcohol and Drug Abuse Prevention and Treatment program, there are challenges in ensuring adequate help for those struggling with alcohol use. This includes addressing the stigma associated with seeking treatment, which often leads to underutilization of available resources. Furthermore, the integration of evidence-based practices for SUD treatment across the military is crucial for addressing this pervasive issue.

Overall, substance use within the Air Force poses a threat to the health and performance of personnel, unit cohesion, and the maintenance of high standards of military discipline and readiness. Addressing these challenges requires a comprehensive approach that includes prevention, intervention, and effective treatment strategies.

Effects of Substance Abuse on Air Force Personnel Performance and Health

Substance use can lead to deteriorating mental health, exacerbate existing medical conditions, and increase the risk of suicide. The Air Force maintains a strict ‘zero tolerance’ policy for illicit drug use, recognizing the potential for substance use to impair military readiness and discipline. Moreover, substance use is linked to a higher incidence of alcohol-related incidents (ARIs) and can undermine the operational effectiveness of Air Force units. The Alcohol Misconduct Prevention Program (AMPP) is one example of an initiative designed to mitigate these risks by reducing ARIs among Airmen.

Furthermore, the culture of alcohol consumption within the military, including binge and heavy drinking, has been identified as a significant health and social functioning issue. The military’s stringent policies and deterrent programs, such as random breathalyzer tests, are aimed at curbing these behaviors to maintain high performance and health standards among service members.

The Effects of Substance Abuse on Unit Cohesion and Morale in the Air Force

Substance use within the Air Force can significantly undermine unit cohesion and morale, which are critical elements for operational effectiveness. Unit cohesion, the bond among unit members, is essential for military performance. Research has shown that low levels of unit cohesion are associated with higher odds of post-traumatic stress disorder (PTSD), psychological distress, and alcohol problems. Conversely, high unit cohesion seems to be a protective factor, reducing the risk of PTSD, major depressive episodes (MDE), generalized anxiety disorder (GAD), alcohol use disorders (AUD/SUD), and suicidal ideation.

Alcohol use, in particular, has been a focus of concern within the military due to its potential to impair judgment and disrupt the discipline necessary for military readiness. The Department of Defense (DoD) has implemented stringent policies to discourage substance use, including alcohol, illicit drugs, prescription drug misuse, and tobacco use. Despite these efforts, problematic alcohol use among service members persists, leading to serious negative consequences on health and readiness.

The culture of alcohol in the military has historical roots, with past norms and even ‘romanticizing’ of alcohol use. Current initiatives aim to shift this culture towards a more sensible approach to alcohol consumption. The relationship between traumatic exposure and mental health outcomes is complex, and unit cohesion plays a significant role in mitigating these effects. Substance use prevention programs and education are mandated for all service members, emphasizing the importance of maintaining high standards of performance and discipline.

Ultimately, the impact of substance use on unit cohesion and morale is multifaceted, affecting individual service members and the collective operational capacity of the Air Force. Therefore, understanding and addressing substance use is critical to maintaining the integrity and effectiveness of military units.

Substance Abuse Trends and Challenges in the Air Force

As the Air Force continues to evolve, so do the challenges related to substance use within its ranks. Future perspectives on this issue must consider the complex interplay of stressors, mental health, and the availability of support and treatment. High-stress jobs like those in the military are associated with a higher likelihood of behavioral health conditions, which can worsen substance use issues. The COVID-19 pandemic has added new layers of stress, potentially leading to increased substance misuse among personnel.

The Air Force maintains a stringent ‘zero tolerance’ policy towards illicit drug use, but the effectiveness of such policies in the changing landscape of substance misuse needs continuous evaluation. The emphasis on self-identification and command referral for treatment suggests a proactive approach, yet barriers remain, such as stigma and inadequate behavioral health service capacity. The underutilization of counseling services, particularly among Reserve component members, indicates a gap that future strategies must address.

Anticipating future trends requires a commitment to ongoing research and the implementation of evidence-based practices across the Department of Defense (DoD) and Veterans Affairs (VA) continuum of care. Enhancing the resiliency of personnel through mental health support and increasing the use of evidence-based protocols in military programs are critical steps. As substance use dynamics shift, the Air Force must adapt its policies and programs to ensure the health and readiness of its service members.

Substance Use Disorder Treatment at The Recovery Village Palmer Lake

There are quite a few different options for people who are seeking treatment for drug & alcohol addiction. Your individualized treatment plan at The Recovery Village Palmer Lake may include:

• Medical detox: Patients detox from substances in a clinical environment where doctors monitor health and provide medications to ease withdrawal symptoms.
• Inpatient treatment: Patients in inpatient treatment live at our facility and attend a full schedule of individual and group therapy, counseling and peer support sessions.
• Partial hospitalization program (PHP): PHPs provide patients with additional flexibility and independence than inpatient programs.
• Intensive outpatient program (IOP): IOPs help patients transition to life outside of rehab, with fewer hours of care and more time building skills and habits for recovery.
• Outpatient treatment: Outpatient care provides ongoing treatment after an inpatient stay and supports patients as they transition back into their daily lives.
• Aftercare: Aftercare programs help support long-term recovery through clinical and medical recommendations for follow-up care, relapse prevention plans and more.

If you or someone you love is struggling with drug or alcohol addiction, help is available. The Recovery Village Palmer Lake is here to support you throughout the entire recovery process. It’s time to get your life back. Call our Recovery Advocates today.